Last Modified: Friday, August 1, 2014 at 6:14 p.m.

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Powell had hired Cowart in 2011 as the mental health agency’s senior vice president of operation and finance, and kept him closely involved in planning for the future and implementing new services for more than 17,000 clients.

Members of The Centers’ board next week will interview Cowart, along with a handful of other applicants, who want the job Cowart has temporarily filled since Powell unexpectedly died in March.

Cowart, 38, first worked at The Centers from 2002 to 2006, beginning as a crisis stabilization coordinator. He left to work for the Highland Tractor Co. as its corporate controller until 2010 and returned to The Centers the next year.

The Centers’ board plans to have a permanent CEO by January.

“That was one of the attractive features (returning to The Centers). I would be part of the succession plan,” Coward said.

But, he said, he never suspected he would be thrust into Powell’s job so soon after returning.

The Centers is a nonprofit organization that provides inpatient and outpatient mental health services in Marion and Citrus counties on seven campuses. The agency employs 550 people and has a $30 million budget.

State funding has been cut by $1.2 million and the Medicaid repayment program by $500,000 annually for the past two years.

The Centers’ board chairman, Gary Norman, said, “I think Tim has done a fine job considering the challenges that were placed in front of him,” citing recent state funding cuts and an overhaul as to how Medicaid reimburses health care businesses.

“I think Tim has done an extremely good job trying to wind us through this financial minefield,” he said.

This week, The Centers eliminated 20 job positions, resulting in 15 employees losing their jobs. The cuts will save about $750,000 annually.

With state funding cuts and changes in how Medicaid reimburses The Centers, leadership believed there was no choice but to eliminate the jobs.

Meanwhile, Cowart said he continues to carry forward The Centers’ new services, many of which were developed by Powell.

For example, The Centers is starting its second year providing clients with services using telecommunications technologies. The program involves clients at a Centers location talking with therapists or other mental health care professionals by way of teleconferencing.

During the first year, the program was limited to substance abuse and group therapy clients. Because of the success and acceptance, it now is offered to outpatients. In that case, outpatients come to The Centers and talk with therapists at a distant location by way of video. Cowart said the therapist has the ability to change the settings of the camera, including zooming in and out during the session.

The next step is to provide the same service to other health care provider clients, such as those who go to the nonprofit Heart of Florida Health Center.

The Centers received a $270,000, three-year grant to pay the cost of the equipment and technical infrastructure and a project manager.

The hope is to one day provide the same service at clients’ homes, so they could talk with therapists and other Centers staff without having to leave their homes.

Alma Rosario, who oversees the program for The Centers, said that while the concept may seem futuristic to some, it is second nature to younger clients.

“The younger generation is already growing up with this,” she said. “To them it’s normal.”

Cowart said the only issue keeping this latest stage from being implemented is funding.

“No one is paying for that right now,” he said.

Offering therapy through telecommunications at clients’ homes would be a great leap forward because the biggest barrier to providing them with help is often their limited transportation options.

The Centers has now also centralized its initial patient assessment strategy.

Initially, potential clients were routed to any of The Centers’ three Marion County campuses for assessment. Now, a group of people tasked only with assessing clients field telephone calls from potential clients, assess them and immediately determine which campus can provide the help they need.

Cowart said the new process is more efficient and far better serves clients.

Cowart also is working with area law enforcement and other health care agencies to develop policies whereby people with mental or behavioral problems who have had run-ins with law enforcement are not immediately taken to jail.

Cowart said he and others are working on pre-arrest diversion programs where law enforcement is part of a referral system that funnels clients to The Centers where their problems can better be addressed.

Cowart is hoping to market some of The Centers’ services, such as its substance abuse programs.

The main facility on Southwest 60th Avenue already has 50 beds for clients wanting rehab for alcohol or drug addiction. Cowart said the The Centers offers the service for less money than many other facilities. The goal is to get the word out about the service and its more affordable cost.

He said that in the past, many private health insurance companies did not pay for residential treatment programs, but now are beginning to.

He said that in many cases, drug and alcohol rehab programs work best when they are conducted in a residential and controlled setting where clients can be continuously observed and helped. That program needs to also be better marketed. Currently, only six of the 15 beds are utilized.

One of the biggest challenges is to increase The Centers’ efficiency and operate it as any other business, Cowart said.

Public funding has become more scarce, and old business practices have to be changed, he said.

“That’s where we are right now as an industry. We have to ensure fundamental business practices are in place to ensure organizations like ours sustain over time,” he said.

“In the past the organization was fundamentally different,” he said. “In the past, when funding was a little more robust, we provided a lot more unfunded care. Now we can’t afford to provide uncompensated care.”

Unfortunately, that means when two clients need a limited service, the one able to pay will likely get it and the other will have to go on a waiting list, he said.

<p>Five months after the death of The Centers' CEO, Tim Cowart sits in Charles Powell's former office as the facility's interim head and waits.</p><p>Powell had hired Cowart in 2011 as the mental health agency's senior vice president of operation and finance, and kept him closely involved in planning for the future and implementing new services for more than 17,000 clients.</p><p>Members of The Centers' board next week will interview Cowart, along with a handful of other applicants, who want the job Cowart has temporarily filled since Powell unexpectedly died in March.</p><p>Cowart, 38, first worked at The Centers from 2002 to 2006, beginning as a crisis stabilization coordinator. He left to work for the Highland Tractor Co. as its corporate controller until 2010 and returned to The Centers the next year.</p><p>The Centers' board plans to have a permanent CEO by January.</p><p>“That was one of the attractive features (returning to The Centers). I would be part of the succession plan,” Coward said.</p><p>But, he said, he never suspected he would be thrust into Powell's job so soon after returning.</p><p>The Centers is a nonprofit organization that provides inpatient and outpatient mental health services in Marion and Citrus counties on seven campuses. The agency employs 550 people and has a $30 million budget.</p><p>State funding has been cut by $1.2 million and the Medicaid repayment program by $500,000 annually for the past two years.</p><p>The Centers' board chairman, Gary Norman, said, “I think Tim has done a fine job considering the challenges that were placed in front of him,” citing recent state funding cuts and an overhaul as to how Medicaid reimburses health care businesses.</p><p>“I think Tim has done an extremely good job trying to wind us through this financial minefield,” he said.</p><p>“So, unless you find someone head and shoulders above Tim Cowart, why change (leadership)?” Norman added.</p><p>This week, The Centers eliminated 20 job positions, resulting in 15 employees losing their jobs. The cuts will save about $750,000 annually.</p><p>With state funding cuts and changes in how Medicaid reimburses The Centers, leadership believed there was no choice but to eliminate the jobs.</p><p>Meanwhile, Cowart said he continues to carry forward The Centers' new services, many of which were developed by Powell.</p><p>For example, The Centers is starting its second year providing clients with services using telecommunications technologies. The program involves clients at a Centers location talking with therapists or other mental health care professionals by way of teleconferencing.</p><p>During the first year, the program was limited to substance abuse and group therapy clients. Because of the success and acceptance, it now is offered to outpatients. In that case, outpatients come to The Centers and talk with therapists at a distant location by way of video. Cowart said the therapist has the ability to change the settings of the camera, including zooming in and out during the session.</p><p>The next step is to provide the same service to other health care provider clients, such as those who go to the nonprofit Heart of Florida Health Center.</p><p>The Centers received a $270,000, three-year grant to pay the cost of the equipment and technical infrastructure and a project manager.</p><p>The hope is to one day provide the same service at clients' homes, so they could talk with therapists and other Centers staff without having to leave their homes.</p><p>Alma Rosario, who oversees the program for The Centers, said that while the concept may seem futuristic to some, it is second nature to younger clients.</p><p>“The younger generation is already growing up with this,” she said. “To them it's normal.”</p><p>Cowart said the only issue keeping this latest stage from being implemented is funding.</p><p>“No one is paying for that right now,” he said.</p><p>Offering therapy through telecommunications at clients' homes would be a great leap forward because the biggest barrier to providing them with help is often their limited transportation options.</p><p>The Centers has now also centralized its initial patient assessment strategy.</p><p>Initially, potential clients were routed to any of The Centers' three Marion County campuses for assessment. Now, a group of people tasked only with assessing clients field telephone calls from potential clients, assess them and immediately determine which campus can provide the help they need.</p><p>Cowart said the new process is more efficient and far better serves clients.</p><p>Cowart also is working with area law enforcement and other health care agencies to develop policies whereby people with mental or behavioral problems who have had run-ins with law enforcement are not immediately taken to jail.</p><p>Cowart said he and others are working on pre-arrest diversion programs where law enforcement is part of a referral system that funnels clients to The Centers where their problems can better be addressed.</p><p>Cowart is hoping to market some of The Centers' services, such as its substance abuse programs.</p><p>The main facility on Southwest 60th Avenue already has 50 beds for clients wanting rehab for alcohol or drug addiction. Cowart said the The Centers offers the service for less money than many other facilities. The goal is to get the word out about the service and its more affordable cost.</p><p>He said that in the past, many private health insurance companies did not pay for residential treatment programs, but now are beginning to.</p><p>Cowart also plans to remodel The Centers' 15-bed, juvenile residential substance abuse center.</p><p>He said that in many cases, drug and alcohol rehab programs work best when they are conducted in a residential and controlled setting where clients can be continuously observed and helped. That program needs to also be better marketed. Currently, only six of the 15 beds are utilized.</p><p>One of the biggest challenges is to increase The Centers' efficiency and operate it as any other business, Cowart said.</p><p>Public funding has become more scarce, and old business practices have to be changed, he said.</p><p>“That's where we are right now as an industry. We have to ensure fundamental business practices are in place to ensure organizations like ours sustain over time,” he said.</p><p>“In the past the organization was fundamentally different,” he said. “In the past, when funding was a little more robust, we provided a lot more unfunded care. Now we can't afford to provide uncompensated care.”</p><p>Unfortunately, that means when two clients need a limited service, the one able to pay will likely get it and the other will have to go on a waiting list, he said.</p><p><i>Contact Fred Hiers at 352-867-4157 or fred.hiers@starbanner.com.</i></p>